Consumption Curable: Observations on the Treatment of Pulmonary Diseases

by Henry Congreve

OF ASTHMA, OR DIFFICULTY OF BREATHING.

There are two distinct kinds of Asthma—one of which is denominated nervous or convulsive—the latter is not the disorder so prevalent in this country as the former. The true Asthma is a laborious breathing, wheezing, sense of suffocation, attended by anxiety, cough, and mucus expectoration. It is very frequent; and no disease is more distressing to the patient.

Asthma is a disease which usually attacks elderly people; and those who are subject to it, have frequent returns—for all the methods in common use are calculated only to promote relief in the present fit, not to produce a lasting cure. If the medical adviser be called in in the extremity of a fit, he bleeds his patient freely; and that practice is become too general, because it often affords immediate relief in the paroxysms, but the fits again return, and often with greater violence than before; and frequent renewals of this practice soon undermine and destroy the constitution.

The phenomena of Asthma arises from increased excitement of the branches of the eighth pair of nerves, distributed over the larynx, and the internal membrane of the wind-pipe, and bronchiæ, brought on by a certain condition of the atmosphere, probably with respect to electric matter: for, opposite states of the air, with regard to its temperature, density, or humidity, do not disorder asthmatic subjects, so much as easterly or north-easterly winds. In consequence of the excitement of the nerves of the larynx, &c., the respiratory muscles, particularly those which perform the functions of expiration, become affected by spasms, whereby the free admission of the irritating air into the lungs is promoted. This is manifest by the excessive paroxysms, very similar to that which ensues on an attack of Asthma, which immediately follows an artificial irritation, the membrane of the larynx. The suffocating sensation produced by a morsel of food lodging in the membrane in the act of swallowing (usually attributed by unprofessional persons to “the food going the wrong way,”) is of this nature. The muscles concerned in expiration immediately contract, to prevent the admission of an obnoxious article into the wind-pipe; and this state of muscles will continue many minutes: and, in asthmatics, whose nerves of the parts are morbidly irritable, it has continued many hours.

It would be incompatible with the design of this pamphlet, and perhaps superfluous to enter minutely into a description of what Asthma is—especially as no disease shows itself more distinctly. The individual, occasionally attacked by wheezing, difficulty of breathing, and tightness of the chest, need not be assured that he is asthmatical; but it will be a source of consolation to inform him, that his case is really curable, by this valuable medicine, as experience in the worst cases has amply confirmed. As the use of the Balsam is persevered in, the paroxysms abate, the attendant cough becomes freer, and is accompanied by gentle expectoration; and, in proportion to the increase of the cough and expectoration, the distressing symptoms decrease—a more free passage of air being now admitted to and from the lungs.

Some individuals are continually asthmatic, and others are subject to it only occasionally, when it comes on in fits: this remedy will be found intrinsically valuable to such, because it will loosen the tough phlegm, which oppresses the lungs and produces shortness of breath, and cause its removal by expectoration.

Those who have a confirmed Asthma, should form the Balsam into a syrup, by mixing with it about an equal quantity of fine honey, (having previously dissolved it by heat, and removed the wax and impurities which arise to its surface,) and, when thus incorporated, taking a dessert spoonful, or two tea-spoonsful, night and morning; and, in some cases, once or twice throughout the day. The paroxysms will speedily terminate, after short perseverance in the use of these means; and, by bringing on a free expectoration, every asthmatic sensation will speedily disappear. When taken in the day-time, it effectually keeps off the evening exacerbation or paroxysm. In cases of winter or irritable cough, arising from an increased excitement of the bronchial nerves, and a certain state of the atmosphere, it is also a most valuable remedy. The Elixir more speedily and permanently allays morbid irritation, or increased excitement of the nerves of the larynx, wind-pipe, and lungs, than any other known remedy.

The only difference between a winter Cough and Asthma is, that the seat of the former is in the membrane lining the bronchial tube, while the latter is in the membrane of the larynx, and upper part of the wind-pipe.

For those who have an Asthma, the attacks of which are periodical, and the fits regular, this Balsam will be highly useful. The fits of this species of the disease come on about every ten days; they are more violent, and last longer in summer than in winter; and the symptoms are highly aggravated by intemperance and irregularity. These fits are certainly rendered much more tolerable, and are slighter when expectoration comes on. The Balsam should therefore be regularly taken in such doses as to produce this: and the approach of the fits should be carefully watched, that the remedy may be taken in sufficient doses prior to the commencement. If the patient feel a tightness about the pit of the stomach shortly after dinner, it is a certain indication that an attack will shortly ensue; in which case, one or two tea spoonsful of the Balsam should be immediately taken, mixed in a similar quantity of honey, or, in absence of honey, lump sugar: he should remain quite still, in an erect posture; and in about half an hour afterwards renew the dose. When the stomach is swelled, and the patient is flatulent, it is an infallible sign that the fit is gaining strength, and a tightness of the chest and lungs will follow. About once in two hours half a spoonful, or more, of the Balsam must be taken for three times more; when the patient should be put to bed, and lie with his head high. The fit often comes on with violence about two o’clock in the morning: the invalid retires to rest fatigued, and inclined to sleep; and, after exhibiting sensations of uneasy restlessness, he falls asleep, and is harassed by uneasy and embarrassed dreams; startings in his sleep, and other nervous symptoms often attend, and indicate the tendency to a fit: he awakes in restless anxiety, and is obliged to toss about, and change his posture, or sit up in bed, in expectation of relief; but, owing to the increase of the spasms, his breathing becomes increasingly impeded, and he pants for breath with unspeakable anxiety. He should then get up, and drink freely of the infusion recommended in Consumption (page [10]); and take a dose of the Balsam incorporated with honey, which will promote the expectoration, and generally carry off the fit. The heat of the bed, and the posture of lying, both increase the complaint.

As aperients, judiciously combined with bitters, tonics, stimulants, or antispasmodics, with a view of promoting the abdominal secretions, without depressing the vital energies, and of deriving from the lungs any accumulation of morbid matter which cannot be expectorated; such a combination with Camphor, as contained in “Dr. Flemming’s Quinine and Camphor Pills” (prepared by the Author in boxes at 4s. 6d. each, containing a Treatise on Indigestion, Diet, and Regimen, &c.) is peculiarly serviceable in this disorder, taken in conjunction with the Balsam, in sufficient doses to remove the accumulation of bile in the biliary organs, and of the sordes retained in the mucus surface of the bowels; and it should be observed that purgatives are always better borne when combined with Camphor, and are then most proper in all stages of the disease. When expectoration is rendered difficult, and the cough suffocating, from the tenacity and consistency of the matter, as is not unfrequently the case, the Balsam, in conjunction with the “Camphor Pills” alluded to, will be found an invaluable remedy. The virtues of Camphor in this disease have been singularly overlooked by the writers on this subject, as an adjunct to other balsamics, pectorals, and expectorants; but administered in this form, it is doubtless the most valuable remedy we possess in this, as well as in several other diseases, and particularly of those consequent on debility or disorder in the digestive organs, which require a tonic, and a stimulating remedy. When the bowels require evacuation, strong purgatives must on no account be resorted to: because such measures tend very considerably to check and diminish expectoration; but gentle aperients of a cooling nature should not be neglected, when a tendency to constipation points out the need of a remedy to relieve the system, and nothing can be better adapted for that purpose than the foregoing combination.

By recourse to these means, the lengthened fits of Asthma will be prevented; and if the disease be established in the constitution, a due perseverance with the remedy will effectually eradicate every symptom.

With regard to the course of life of the asthmatic—great care should be observed to choose a proper air; experience will soon point out what air is best, and no certain rule can be definitely given. Where the patient breathes most easy he ought to reside. He should lie with his head high, and not be too much encumbered with bedclothes; must avoid a stooping or a leaning posture; when he writes, use a high desk; and read sitting upright; and should always accustom himself to moderate and gentle exercise. These cautions are important, for, by their observance, with a moderate diet, early rising, and light supper—an increase of the disorder will be prevented; and the use of the Balsam will subdue what is already established in the constitution.

The patients beverage should also receive particular attention. Barley-water and lemonade, but especially the infusion before referred to, may be freely taken. Change of air will generally prove beneficial; and flannel worn next the skin be of service. Constipation of the bowels must be avoided; and whenever that disposition is manifest, immediate recourse should be had to such an aperient remedy as above described.